Yup, I paid the $500 fee, also. It covers expenses that insurance does not cover and it helps them run the (very important and very helpful) informational seminars every month. Also only people who are serious about the surgery will want to pay the fee. Attending two seminars is mandatory because you will get to meet both doctors and hear many different people who have had the surgery share their results. I was glad I went to both. Also there are other bariatric programs that require 4-6 informational sessions...so two is not bad! It does seem like this surgery is a long drawn out process, but it is well worth the wait. I began the process in August of 08 and was banded in February of 09. I have lost 45 pounds and I feel terrific! I do not feel deprived and I can eat my favorite foods...don't get discouraged!